CapitalNurse is jointly sponsored by Health Education England, NHS England and NHS Improvement

Preceptorship Framework

September 2017

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Table of Contents

Introduction ........................................................................................................................ 3

Background ........................................................................................................................ 3

What is Preceptorship? ...................................................................................................... 4

CapitalNurse Preceptorship Standards .............................................................................. 5

Who is preceptorship for? ............................................................................................... 5

Preceptor / preceptee charter ......................................................................................... 5

Length of programme ..................................................................................................... 5

Protected time ................................................................................................................ 6

Meetings between Newly Registered Nurse and Preceptor ........................................... 7

Preceptee ....................................................................................................................... 7

Preceptors ...................................................................................................................... 7

Preceptor Support and Development ............................................................................. 8

Preceptorship Lead ........................................................................................................ 8

Organisational Commitment .............................................................................................. 9

Preceptee Development ................................................................................................. 9

Appendix One - CapitalNurse Domains ........................................................................... 10

Appendix Two - Charter between the preceptor and the preceptee ................................. 13

Appendix Three – Meeting Templates ............................................................................. 15

Appendix Four - Role Descriptor for a Preceptor ............................................................. 20

Authors ............................................................................................................................ 21

Acknowledgements .......................................................................................................... 21

References ...................................................................................................................... 22

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Introduction

This preceptorship framework is a resource for health and care organisations pan-

London to support the practice of newly registered nurses. This recommended ‘best

practice’ approach to preceptorship has been developed through an extensive

stakeholder engagement exercise involving practitioners from organisations across

London, representing all fields of practice and settings across acute, community and

primary care. Engagement has encompassed meetings, workshops, the CapitalNurse

conferences, sharing best practice and ‘deep dives’ across organisations. This approach

recognises that where preceptorship is firmly established as part of the organisational

culture, there are significant benefits for the newly registered nurses, other staff and the

organisation itself in terms of retention, recruitment and staff engagement.

Background

One of the aims of the CapitalNurse programme is to decrease variation in education and

practices in London to reduce attrition and to retain nursing staff to ensure that we have

the right number of nurses with the rights skills in the right place at the right time. One of

the four work streams focuses on standardising current practices with specific reference

to preceptorship by developing a standardised approach pan- London.

Preceptorship was introduced as part of Project 200o reforms and evidence shows that

this period of time when transitioning from student to registered nurse is very valuable for

newly registered nurses (HEE Response to Raising the Bar, Shape of Caring, 2016).

Health Education England (HEE) (2015), published preceptorship standards for

organisations to clarify the requirements of preceptorship as part of the Shape of Caring

Review. This outlines areas of best practice and included 14 required elements.

Odelius et al (2017), undertook a literature review evaluating the value of implementing

nursing preceptorship. The findings show that the majority of preceptees benefit from

increased competence and confidence through a preceptorship programme. A minority

find it less useful either because they are in a specialist area or due to poor relationship

with their preceptor. The study identified different approaches offering different benefits.

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The conclusions drawn showed that organisational commitment and culture were

essential in establishing, implementing and sustaining effective preceptorship

programmes. The benefits of a standardised approach were identified through this

literature review.

HEE’s national Reducing Pre-registration Attrition and Improving Retention (RePAIR)

project is scheduled to report in the Spring of 2018. This work focuses on the fields of

nursing, midwifery and therapeutic radiography. The focussed group work, with students,

has highlighted just how important the model of preceptorship is. Many students who

have the option to choose where they work immediately post-registration, are influenced

by the preceptorship model on offer, and the commitment of the employer to this

programme. RePAIR also includes work with preceptorship leads from the project case

study sites and the early evidence is that students and preceptorship leads value a

programme that is a minimum of 12 months’ duration.

A review of preceptorship programmes examining preceptorship (Currie, L & Watts C,

2012) concluded that organisational commitment was essential and outlined the key role

requirements to support successful preceptorship.

What is Preceptorship?

Newly registered nurses (NRN) become accountable as soon as they are registered and

this transition from student to accountable practitioner is known to be challenging

(Higgins et al 2010). The purpose of preceptorship is to provide support during this

transition. Preceptorship programmes may include classroom teaching and attainment of

role-specific competencies, however the most important element is the individualised

support provided in practice by the preceptor. The goal of preceptorship is for the newly

registered nurse to develop their confidence and autonomy.

The Department of Health define preceptorship as “a period of structured transition for

the newly registered practitioner during which he or she will be supported by a preceptor,

to develop their confidence as an autonomous professional, refine skills, values and

behaviours and to continue on their journey of life-long learning” (DoH, 2010: p11).

Currently the NMC states that a new registrant on a preceptorship programme should

have learning time protected in their first year of qualified practice and access to a

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preceptor with whom regular meetings are held. They also strongly recommend that all

new registrants should have a formal period of preceptorship of about four months but

this may vary according to individual need. In 2018 the NMC will launch new guidance on

pre-registration nurse training and the supervision of students in practice. This will bring

new challenges for the preceptorship period and the preceptors supporting this ‘future

nurse’. This preceptorship framework will evolve to incorporate those changes and

acknowledge the needs of a new registrant in 2020.

CapitalNurse Preceptorship Standards

The following set out the basic preceptorship standards, which are expected of all health

and care organisations in London.

Who is preceptorship for?

Preceptorship should be available to all newly registered nurses. The overall aim of a

preceptorship programme is to develop confident and competent practitioners

Preceptorship may be utilised by an organisation for other nurses such as overseas

nurses, return to practice nurses, or new to General Practice nurses, and is also pertinent

for Allied Health Professionals. This is not a comprehensive list; it is an organisational

decision as to who can access preceptorship. For the purposes of this document

preceptorship is conceptualised as applicable to the newly registered nurse, although

much that is contained here should be applicable and useful to other groups, as

described.

Preceptor / preceptee charter

This sets out the responsibilities and expectations for both preceptor and preceptee. This

is available in Appendix Two.

Length of programme

The recommended length of a preceptorship programme is 12 months from the date of

joining the organisation. It is an organisational decision to wait until a newly registered

nurse receives their pin number.

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The length of preceptorship may be flexible for some in terms of individual needs or

organisational requirements. It should be a minimum of 6 months for all newly registered

nurses, which falls in line with national recommendations of 6-9 months.

Some organisations may choose to include preceptorship as part of a postgraduate

training programme, which offers structured development for up to 2 years post

registration.

During the 12-month programme there will be certain expectations of both the preceptor

and preceptee in terms of engagement in the relationship and completion of defined

competences. These should comply with HEE Standards and examples of indicative

content of a preceptorship programme can be found in Appendix One.

It should include a minimum supernumerary period of two weeks to cover organisation

induction and local induction. Some environments, organisations or individuals may

require more than two weeks. This should be agreed locally with the preceptor and line

manager and the expected outcomes of the supernumerary period made explicit.

Protected time

Protected time should be allocated for both the preceptor and the preceptee, which

should be supported by the organisation.

The purpose of this protected time is to support the NRN, build confidence and

competence, consolidate learning and build resilience. This can be achieved through a

combination of working together with a preceptor, reflection, action learning, supervision

and work-based learning.

The provision and format of this protected time may vary dependent on the working

environment.

The recommended requirements are:

The preceptee and the preceptor should work alongside each other at least four

working days in the first month.

Regular formal meetings during the preceptorship period.

Half-day initial training workshop for preceptors – blended learning approach

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Meetings between Newly Registered Nurse and Preceptor

It is recommended that there are formal review meetings between the preceptor and

preceptee at regular intervals during the preceptorship period: Initial meeting – to set

expectations and learning plan

Interim meetings to monitor progress, share reflection and further consider

development needs. It is recommended that these formal reviews are held at 3, 6 and

9 months

Final meeting to establish competence and sign off after 12 months (this can be done

earlier if all standards and requirements have been completed)

The purpose of these meetings is to provide a supportive safe place for the preceptee to

reflect on their progress and experience. Meetings should be documented briefly, and

this record dated and signed by both the preceptor and preceptee. Templates to help

guide the meetings can be found in Appendix Four.

The timing of preceptorship meetings may be amended and outcomes shared with the

appropriate manager, in order to inform decisions about the probationary period.

Preceptee

The preceptee or newly registered nurse is responsible for engaging fully in the

preceptorship programme. This involves a number of activities including completing

induction and other required training, attending regular meetings with their preceptor,

actively seeking feedback, escalating concerns, reflecting on their professional practice

and taking ownership of their own development.

Preceptees should be encouraged to utilise their preceptorship period, and develop their

portfolio towards NMC revalidation. It should be recognised that although formal study

days are important, learning is achieved in a variety of ways including observation,

workplace learning, e-learning, experiential learning, reflection and working with others.

The preceptee should be encouraged to make full use of all of these opportunities for

learning.

Preceptors

Preceptors should be nurses with a minimum of 12 months’ experience working as a

registered nurse. They may volunteer or be asked to undertake the role by their lead

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nurse, line manager or clinical nurse managers. Research shows that the best

preceptors are those who are volunteers and have more recent experience of being

newly registered.

A preceptor should have no more than two preceptees at any one time. Some

organisations may adopt a team preceptorship model.

The role of the preceptor is to provide guidance to the preceptee by facilitating the

transition into their new role. The preceptor supports the preceptee to gain experience

and apply learning in a clinical setting during the preceptorship period. A role descriptor

for a preceptor can be found in Appendix Four.

Preceptor Support and Development

Preceptors should be prepared for their role and the offered some development in

understanding the preceptorship programme and skills required. Ongoing support for

preceptors should be available from the organisation leads. A pan-London approach to

preceptorship development is currently being developed by CapitalNurse and further

information will be provided to organisations in due course.

Preceptorship Lead

Each organisation should have an appointed preceptorship lead who is responsible for

overseeing the preceptorship programme which may include:

Identifying preceptors, knowing who they are and providing appropriate level of

preparation and support

Identifying all newly registered nurses requiring preceptorship and others for whom

preceptorship is deemed beneficial

Allocating or delegating the responsibility for identifying preceptors in time for the

preceptees start date

Monitoring and tracking completion rates for all preceptees

Performing regular checks that the preceptor / preceptee relationship is working

satisfactorily

Identifying any development / support needs of preceptors or preceptees

Measuring the effectiveness and impact of preceptorship programmes on retention

and staff engagement

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Ensuring preceptorship is operating within the DH framework (2010)

Organisational Commitment

Preceptorship requires organisational commitment to support the programme, the

preceptorship lead, preceptors and the preceptees. Organisations are responsible for

monitoring the programmes and measuring success against key performance indicators,

which could include:

Retention of NRNs after one year

Retention of NRNs after two years

Staff engagement – general or specific groups, i.e. preceptees and preceptors

Patient / service user feedback

CQC ratings against key criteria of safe, effective, caring, responsive and well-led

Preceptee Development

Preceptees should be provided with learning opportunities, including study

days/sessions, over the first year, in addition to the supernumerary period. The content,

frequency and running of these study days/sessions will depend on the organisation’s

needs, however the purpose is to ensure that the preceptee is able to meet the required

clinical and professional competences by the end of their preceptorship period.

Areas should include the nine domains of the CapitalNurse Career Framework, which

incorporates the fourteen elements outlined in the HEE standards, as referenced in

appendix one.

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Appendix One - CapitalNurse Domains

The following provides additional description for the nine domains of the CapitalNurse

Career Framework) to inform preceptee development programmes to be completed over

the 12 months*

Capital Nurse Framework

Domain

What it means – behaviours and outcomes

Clinical Practice

Delivering person-centred, safe and effective care

Assessing and managing risks in delivering safe

effective care to patients

Maintaining own skills and competence

Communication Sharing of health and care related information

between a nurse and those in their care with both

participants as sources and receivers. Information

may be verbal or non-verbal, written or spoken

Understanding techniques to facilitate courageous

conversations

Understanding ways of managing conflict, taking

ownership and using effective communication in

difficult situations

Teamwork

Working effectively as part of a team to achieve

value-added patient, staff and organisational

outcomes

Working with colleagues and other multi-

disciplinary professionals to provide a cohesive

approach to patient care

Understanding the components of effective team

work

Leadership Effectively utilising personal skills and attributes to

inspire people to achieve a common goal

Taking ownership and responsibility for self and

practice. Acting as a role model for others

Understanding role as a leader, reflect on

leadership styles and qualities of a good leader

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Professionalism and Integrity

Demonstrating a strong sense of professionalism

through values, behaviours and relationships in line

with NMC Code of Conduct (2015)

Understanding range and remit of roles and scope

of own responsibility.

Understanding professional accountability

surrounding delegation

Research and Evidence Contributing to the body of nursing knowledge and

using evidence to inform safe and effective practice

Understanding quality measures i.e. KPIs, friends

and family, patient experience

Seeking out ways to develop and improve quality

of practice and care

Safety and Quality

Reducing the risk of harm and ensuring the best

possible health outcomes for those receiving care

Taking active measures to reduce the risk of harm

and ensure the best possible health outcomes for

people receiving care.

Understanding risks and safe levels of staffing.

Knowing how and with whom to raise issues

Understanding the appropriate policies

Facilitation of learning Creating an environment for learning and engaging

in teaching and assessment

Learning with and from others, teaching others to

improve patient care and collaboration

Understanding each other’s professional roles and

their contribution to the patient journey

Actively reflecting on positive and difficult situations

and learning from these to improve practice

Providing preceptees with the opportunity to reflect

on their practice, individually and with peer support

Development of self and others Helping self and others to identify learning needs

and opportunities to achieve agreed goals

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Taking an active part in own professional, personal

and clinical development with PDP in place and

planned learning activities

Understanding NMC revalidation requirements

Using emotional intelligence to work for, rather than

against, promoting good working relationships

Finding ways to manage stress and develop

resilience

Identifying support networks and how to access

help

* Content included in the CapitalNurse domains aligns to the key elements outlined in the HEE Standards.

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Appendix Two - Charter between the

preceptor and the preceptee

Preceptee

I, ________________________________ commit to fulfilling my responsibilities as a newly

registered practitioner and preceptee. This includes:

Completing all organisation and local induction, statutory and mandatory training

Attending study days and doing all required training to complete my preceptorship

Observing and adhering to organisation values

Participating fully in the preceptorship programme by preparing for and attending

meetings as scheduled with my preceptor

Working collaboratively with my preceptor to share my reflections and identify

learning and development needs

Seeking feedback from others to inform my progress

Owning my learning and development plan

Signature:

Date:

Preceptor

I, ________________________________ commit to fulfilling my responsibilities as a

preceptor. This includes:

Providing support and guidance to the newly registered nurse

Acting as a role model and critical friend

Facilitating introductions and promoting good working relationships

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Participating in all preceptorship activities including completing required training,

preparing for, attending and documenting regular scheduled meetings

Providing timely and appropriate feedback to the preceptee

Liaising with manager about preceptee’s progress as appropriate

Advising on learning and development needs, facilitating a supportive learning

environment and signposting learning resources

Signature:

Date

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Appendix Three – Meeting Templates

The following templates are suggested formats for formal review meetings to be

completed by both preceptor and preceptee, signed, dated and each maintaining a copy.

INITIAL MEETING

Preceptee Name:

Preceptor Name:

Date of Meeting:

Expectations:

Induction Checklist:

Study days / eLearning Planned:

Development plan:

Objectives should be SMART – Specific, Measurable, Achievable, Realistic and Timebound

Comments / Notes:

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Next Meeting Date:

Preceptee Signature:

Preceptor Signature:

Date:

INTERIM MEETING

Preceptee Name:

Preceptor Name:

Date of Meeting:

Reflection on what has gone well and any challenges:

Study days / eLearning completed. Future study days planned:

Review of previous development objectives:

Development plan:

Objectives should be SMART – Specific, Measurable, Achievable, Realistic and Timebound

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Comments / Notes:

Next Meeting Date:

Preceptee Signature:

Preceptor Signature:

Date:

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FINAL SIGN-OFF MEETING

Preceptee Name:

Preceptor Name:

Date of Meeting:

Reflection on what has gone well and any challenges:

Study days / eLearning completed. Future study days planned:

Review of previous development objectives:

Development plan:

Objectives should be SMART – Specific, Measurable, Achievable, Realistic and Timebound

PRECEPTORSHIP SIGN-OFF DECLARATION

This is to confirm that the preceptee has completed all aspects of the preceptorship

programme satisfactorily

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Preceptee Name: Signature:

Preceptor Name: Signature:

Organisation Lead Name:

Date of completion:

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Appendix Four - Role Descriptor for a

Preceptor

Role Overview

To provide guidance to the graduate nurse by facilitating the transition from student to

registered nurse by gaining experience and applying learning in a clinical setting during

the preceptorship period.

Responsibilities

The role of the Preceptor is to:

1. Possess a good understanding of the preceptor framework requirements and

communicate these to the newly registered nurse clearly and concisely

2. Ensure induction has been completed and check that the NRN is fully aware of local

ways of working and appropriate policies

3. Facilitate introductions for the newly registered nurse to colleagues, multi-disciplinary

staff and others, promoting effective working relationships

4. Guide in assessing learning needs and setting achievable goals with regular and

confidential review with the newly registered nurse

5. Use coaching skills to enable the newly registered nurse to develop both clinical and

professionally and to develop confidence

6. Facilitate a supportive learning environment by signposting resources and actively

planning learning opportunities for clinical, professional and personal growth of the

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newly registered nurse

7. Give timely and appropriate feedback to newly registered nurse on a regular basis

8. Act as a critical friend and advocate

9. Liaise with the line manager to monitor progress and address areas of poor

performance or areas requiring further development through objective setting and

regular review

Authors

Louise Morton, Dean of Healthcare Professions, Health Education England, north,

central and east London (NCEL) local office

Jenny Halse, Professional Lead for Nursing, Health Education England NCEL

local office

Desiree Cox, Project Manager, Health Education England NCEL local office

Acknowledgements

With many thanks to our Steering Group:

Lorraine Szeremeta, Deputy Director of Nursing, UCLH NHS Foundation Trust

Maggie Orr, Practice Development Lead, CNWL NHS Foundation Trust

Debbie Dzik-jurasz, Deputy Director Education Barts Health NHS Trust

Dr Sinead Mehigan, Head of Department, Adult, Child and Midwifery, School of

Health and Education, Middlesex University

Mags Jubb, Education, Training and Development Manager, Clinical Education,

Guys & St Thomas’ NHS Foundation Trust

Olwen Minford, Health Education England

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Anne Macrae, Joint Practice Nurse Lead, Lambeth CCG

Alison Epton, Wandsworth CEPN, Lead Nurse for Education

We would also like to thank all those who have participated in stakeholder engagement

forums and/or provided feedback, for their time and contribution, in particular:

Walter Burog, CPH Preceptorship, UCLH NHS Foundation Trust

Estelle Fivash, Practice Development Nurse, UCLH NHS Foundation Trust

Vanessa Keane, Practice Educator for Newly Qualified Nurses, Great Ormond

Street Hospital NHS Foundation Trust

Kit Tong, Preceptor Lead, North West London Hospitals NHS Trust

Dean Gimblett, Preceptor Lead, Camden and Islington NHS Foundation Trust

Winnie George, Senior Nurse Preceptorship Barts Health NHS Trust

References

Currie L, Watts C (2012) Preceptorship and pre-registration nurse education

www.williscommission.org.uk/__data/assets/pdf_file/0011/479936/Preceptorship_and

_pre-registration_nurse_education.pdf (Last accessed: 2 March 2017.)

Department of Health (2010) Preceptorship framework for newly qualified nurses,

midwives and allied health professionals. London. Department of Health. Online.

Available at:

https://hee.nhs.uk/sites/default/files/documents/DoH%20Preceptorship%20Framewor

k%20for%20newly%20registered%20nurses%20midwives%20and%20allied%20healt

h%20professionals%202010.PDF (Last accessed 4 August 2017)

Evans J., Bell J., Sweeney A.E., Morgan J., & Kelly H. (2010) Confidence in critical

care nursing. Nursing Science Quarterly 23 (4),334-340

Health Education England (2016) Raising the Bar: Shape of Caring: Health Education

England’s Response. www.hee.nhs.uk/sites/default/files/

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documents/Raising%20the%20Bar%20-%20 Shape%20of%20Caring%20-

%20HEE%27s%20 response.pdf (Last accessed: 3 August 2017)

Health Education England (2015) Health Education England Preceptorship standards.

Online. Available at:

https://hee.nhs.uk/sites/default/files/documents/Preceptorship%20Standards%202015

.pdf (Last accessed 4 August 2017)

Higgins G., Spencer R.L. & Kane R. (2010) A systematic review of the experiences

and perceptions of the newly qualified nurse in the United Kingdom. Nurse Education

Today 30, 499-508.

Odelius, A., Traynor, M., Mehigan, S., Wasike, M. & Caldwell, C. (2017) Implementing

and assessing the value of nursing preceptorship. Nursing Management 23, 9, 35-37